Hallo Harald,

in den europäischen Leitlinien

https://www.ese-hormones.org/media/3823/ese-clinical-guideline_-treatment-of-chronic-hypoparathyroidism-in-adults.pdf

heißt es:

R.2.6 We suggest aiming at an adequate vitamin D status.

Begründung:

Reasoning “ Vitamin D insufficiency has been associatedwith adverse effects on skeletal as well as extra-skeletalhealth (61). Severe vitamin D deficiency is associated with symptoms of myopathy, and patients with HypoPT often have neuromuscular complaints (4, 38, 53). To ensure that symptoms are not caused by low vitamin D levels, it seems reasonable to ensure an adequate vitamin D status (55). A serum concentration of 25-hydroxyvitamin D (25OHD) above 50 nmol/l (20 ng/ml) may be considered as adequate (41, 62, 63). Remarks “ Treatment with activated vitamin D analogues does not ensure an adequate vitamin D status in terms of serum 25OHD levels. As calciferol itself may be of importance to a number of cellular processes and may undergo hydroxylation to 1,25(OH) 2 D catalyzed by local hydroxylases in different tissues (64), it seem reasonable to ensure sufficient 25OHD levels, despite treatment with activated vitamin D analogues.

und

R.3.6 We recommend vitamin D supplementations in a daily dose of 400–800 IU to patients treated with activated vitamin D analogues.

Beim Monitoring steht allerdings nur:

R.4.1 We recommend routine biochemical monitoring of serum levels ionized or albumin adjusted total calcium, phosphate, magnesium and creatinine (estimated glomerular filtration rate (eGFR)), as well as assessment of symptoms of hypocalcaemia and hypercalcaemia at regular time intervals (e.g. every 3–6 months).

Will man aber das genannte Ziel eines adäquaten Vitamin D-Status erreichen, muss man den Status doch erstmal messen und nach Supplementation auch kontrollieren, nur nicht so oft und regelmäßig wie die anderen Werte.

In den DGE Behandlungsempfehlungen steht Vitamin D nicht in der Liste regelmäßig zu prüfender Werte.

Viele Grüße

Frauke